Medication vending devices are well-known in the art. See, for example, U.S. Pat. No. 9,117,010 (Feldman et al.), which is incorporated herein by reference in its entirety. One feature of such devices is that the devices and/or their related host site that maintains a patient-specific electronic medication administration record (eMAR)) may be programmed to generate alerts to patient caregivers (e.g., patient's medical care provider, family or friend) if any medications are not vended in accordance with a pre-programmed dosing schedule (also, referred to in the art as a “dosage schedule” or a “dose schedule”).
Medical diagnostics devices exist today for measuring a large number of different parameters of the human body. These devices range from simple devices such as weight scales (e.g., parameter=weight) to complex blood sampling and analysis devices (e.g., parameter=white blood cell count). Many of these devices have “smart” capabilities, such as the ability to send alerts to pre-programmed entities when or if the measured parameters are outside of a predefined range.
The goal of most medication regimens is to maintain one or more parameters of the human body at a predefined level. Some of the parameters may be life-threatening if they divert significantly from the predefined level. The presumption is that adherence to a medication regimen by following the pre-programmed dosing schedule will maintain the parameter at the predefined level. This is why the alert feature of the medication vending device is important because an adherence failure may result in the parameter not being maintained at the predefined level.
However, in some instances, a medication is prescribed for a particular condition, but the medication, even when taken correctly, fails to address the condition, or after an initial period of success, the medication subsequently fails to address the condition. The alert feature of the medication vending device is not always useful in these instances, because no alert condition will be detected as long as the medication is being taken as directed.
A medication failure may be eventually detected when the patient visits a medical provider, but a significant period of time may elapse before such detection. However, the medical provider has no way to know for sure whether the medication failure was the result of non-adherence to a medication dosing schedule, or failure of the medication to perform as expected. This is because patients may either be untruthful about following the medication dosing schedule, or may not be able to respond with confidence as to whether they properly followed the medication dosing schedule, such as when the patient has cognitive impairment.
Accordingly, there is a need for more sophisticated functionality in a medication vending device and/or related system that can assist in detecting medication failures, even when a medication dosing schedule is being adhered to. The present invention fulfills such a need.
A medication vending device typically includes some form of alert each time that medication is scheduled to be taken in accordance with a dosing schedule that is set in the device. Typically, the alert is audible and/or visual. The alert is then turned off after a vending event is detected. For patients who are highly compliant with the dosing schedule after a lengthy period of time, the alert is not likely to be providing any useful assistance for the patient, and may be a source of annoyance, especially if the alert is audibly loud. For patients who have low (poor) compliance with the dosing schedule, the alert is very important, but since the alert is set for a typical patient, it may not be sufficient for the low compliance patient. Also, it may be necessary to provide alternative forms of alerts for such patients that are not provided at all for the normal patient. Notwithstanding these considerations, the common practice of medication vending devices is to provide only one default mode of alerts for all patients.
Accordingly, there is a need for more sophisticated functionality in a medication vending device and/or related system that can provide adaptive adherence intervention so that the alerts are modified based on actual degree of compliance data. The present invention fulfills such a need.
As discussed above, a medication vending device is pre-programmed with a dosing schedule. A sample dosing schedule is shown in FIG. 43 of U.S. Pat. No. 9,117,010. A patient's regular, daily sleep/wake cycle, or activity schedule may prevent the patient from strictly adhering to the dosing schedule. In such an instance, the patient will show low (poor) compliance with the dosing schedule. This may lead to generating a large number of alerts, which may trigger communications with a caregiver regarding the low compliance. However, if the low compliance is due to the patient's regular, daily sleep/wake cycle, or activity schedule, the patient will not be able to improve their compliance level.
Accordingly, there is a need for providing an adaptive dosing schedule that would permit predefined variations to be made to the dosing schedule when low compliance issues arise. The present invention fulfills this need.